Let me ask you a question: Do you believe that there is a such a thing as a vegan Paleo or Eco Atkins diet? No? Well, me neither, at least until, I read about the latter, i.e. Eco-Atkins, in the title of a long-term (6-months) weight loss study by David J A Jenkins and his colleagues from the University of Toronto that was recently published in the peer-reviewed scientific journal BMJ Open (Jenkins. 2014). If you take a look at the actual macros of the alleged "low-carbohydrate vegan diet", it's ~40% carbohydrate content and its relatively high protein content (~23%), as well as the focus on high quality plant food this whole thing does yet rather look like "vegan Paleo" than "Eco Atkin".

Vegan paleo with two deadly sins: Soy and (even worse) gluten protein! While only one-third of the 20 overweight participants (ntotal = 40) who had originally been randomized to the active arm of the study actually consumed the prescribed amount of soy and gluten protein, the mere fact that they still made up the lions share of the diet will probably have one or the other conservative paleo worshiper shake his heads about the results.

Figure 1: The macronutrient compo-sition of the prescribed "Eco-Atkins" diet looks much different from what the subjects actually ended up eating - despite reporting bias, by the way.

How exactly was Eco-Atkins supposed to look like? The major carbohydrate sources on what was supposed to be a low carbohydrate diet featured viscous fibre-containing foods (such as oats and barley) and low-starch vegetables (emphasizing okra and eggplant) for the relatively limited amount of carbohydrate allowed. The vegetable proteins were prescribed as gluten (54.8% of total protein), soy (23%), fruits and vegetables (8.7%), nuts (7.5%), and cereals (6%). Gluten was contained in the nut bread and wheat gluten (also called ‘seitan’) products. Soy protein was present in the form of burgers, deli slices, breakfast links, veggie bacon, tofu and soy milks. Nuts included almonds, cashews, hazelnuts, macadamia, pecans and pistachios. The fat sources were nuts (43.6% of total fat), vegetable oils (24.4%), soy products (18.5%), avocado (7.1%), cereals (2.7%), fruits and vegetables (2.3%), and seitan products (1.4%).

Results that confirm, once again, that the keys to weight loss success are a significant, but not exorbitant energy deficit (here -24%) and the removal of 90% of the processed junk 99% of the average Joes and Janes call "food" (shocking truth: More ~25% of the male adolescents consume Pizza everyday, see figure in recent Article from The Atlantic)

If the replacement is relatively high in protein and fiber and contains "super foods", such as nuts, this is an extra bonus of which you can see that it had the "Eco Atkins" diet outperform its lacto-ovo vegetarian (higher carb) competition in almost all health- and physique relevant markers the Canadian researchers assessed. And still, the conclusion the wording of the conclusion is, as so often, misleading:

Figure 3: De facto dietary composition in the two groups (Jenkins. 2014)

"We conclude that a weight loss diet which reduced carbohydrate in exchange for increased intakes of vegetable sources of protein, such as gluten, soy and nuts, together with vegetable oils offers an opportunity to improve both LDL-C and body weight, both being risk factors for CHD.

Further trials are warranted to evaluate
low-carbohydrate diets, including more plant-based lowcarbohydrate diets, on CHD risk factors and ultimately
on CHD." (Jenkins. 2014)

With a reported ~40% vs. 54% carbohydrate intake (see Figure 3)and an adherence to the diet protocol that was <30% even in those 10 out of 20 subjects who were initially randomized to the "Eco Atkins" group, it's of paramount importance to mind the exact wording, here. The "reduced carbohydrate diet", the subjects consumed had after the macronutrient composition of a "Vegan paleo" (another oxymoron, by the way) diet - not that of an "Eco Atkins" (or more appropriately "vegan Atkins") diet the scientists actually wanted to investigate.

Figure 4: Irrespective of tons of gluten and a adherence rates of <33% the "Eco Atkins" brought about significant improvements in all relevant health markers (data expressed rel. to baseline Jenkins. 2014)

The main take home message of the study is thus food quality and quantity rule. If those are in place, the macros will usually come on their heels - just like the desirable weight loss and health effects, by the way. In that, the answer to the question how "high" the quality of the prescribed "Vega paleo" or "Eco Atikins" (call it whatever you want) eventually was, is obviously debatable. The data in Figure 3 on the right hand side of this conclusion, as well as the additional information that the main marker of inflammation, i.e. hsCRP dropped by 13% despite the high amount of gluten in the "Eco Atkins" diet do yet would suggest that the contemporarily highly popular neo-paleolithic gluten scare is more than overblown.

Consequently, the exclusion of all gluten containing foods should by no means be presented as an obligatory first step on an individuals way towards a healthier lifestyle. The dropout and adherence rates of 50% and <33% of the study at hand do after all leave no doubt that the surprisingly successful baby-steps the 10 dieters who made it past the finish line of this 6-months dietary intervention took were already hard enough.

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